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The procedure of pulling a tooth is called an extraction. Teeth need to be extracted for a variety of reasons:
- If there is gum disease (periodontal disease) and the bone is lost around the tooth
- If there is a lot of decay in the tooth and it cannot be restored
- If there is trauma to the face or mouth that affects the teeth
- To have a successful orthodontic treatment (such as braces to straighten teeth) to get the best result possible (1)
What is the right tooth extraction procedure?
An oral surgeon is a dentist that specializes in extracting teeth. Other dentists can also pull teeth when necessary, but the oral surgeon performs a whole range of simple and complicated procedures.
The right procedure is the one that is the safest for the patient and the least invasive possible.
When permanent adult teeth need to be removed, the bone should be preserved as much as possible. (2) Bone preservation creates a good environment for the placement of a dental implant later.
What happens after tooth extraction?
After the tooth is removed, the surgeon may place stitches to keep the area closed. Sometimes, the surgeon will have you bite down on a thick cotton square to help stop the bleeding.
If you were put to sleep for the procedure, you might be taken to a recovery room so you can fully wake up before you go home. You should not eat anything until the numbness wears off.
What foods are to be avoided?
Wait until you are no longer numb to begin eating after tooth extraction. If you are still numb, you may bite your lip, tongue, or cheek without realizing it.
Make sure any gauze that was placed to stop the bleeding is out of your mouth. Avoid hot foods and drinks, as well as spicy and hard foods. Avoid sucking liquids through a straw. Alcohol should be avoided, as well.
The clot that is supposed to form in the area where the tooth was removed should not be disturbed so that proper healing can take place.
What foods can be eaten after tooth extraction?
Soft foods that are not very hot are the best foods to eat after tooth extraction. Mashed potatoes, smoothies, eggs, pasta, applesauce, and soups that are not very hot are some examples of foods that are safe to have.
How long is this diet change needed?
For the first 24-48 hours after a tooth extraction, it is best to stick to a soft-food diet. After that, you can progress to more substantial foods such as toast and oatmeal as you can tolerate them.
Cold foods may help with some of the discomforts you may be feeling.
Is smoking and drinking to be avoided completely after extraction?
The goal after a tooth extraction is for the area to heal completely with the least amount of complications as possible.
A dry socket is a painful condition that can happen after an adult tooth is extracted. It happens when the blood clot at the site of the extraction does not develop or is removed.
Non-smokers have fewer cases of painful dry sockets than smokers do. It has been found that smoking has a negative effect on the healing of extractions. (3)
Tobacco causes blood vessels to constrict or narrow, and that can influence the way the surgical wound heals. The chemicals, such as carbon monoxide that are produced from smoking can lessen blood flow.
Even a single cigarette can lessen blood flow by 40% in 1 hour. Smoking on the day of the tooth extraction has been seen to increase the likelihood of a dry socket. The sucking on a cigarette may move the clot from the bone and prevent proper healing. (4)
Alcohol consumption should be avoided after tooth extraction. Twenty-five percent of cases found to develop dry sockets were in patients that smoked or consumed alcohol, or both. (5)
It seems that alcohol depresses the immune system and can make the patient more susceptible to infection. (6)
What are the reasons a dentist may recommend a tooth extraction?
The most common reason for a dentist to recommend removing a tooth is decay, which is also called dental caries. Over 50% of the teeth that have been pulled were removed because they were very decayed.
As mentioned, teeth are also extracted for orthodontic reasons where there is crowding in the mouth. Extractions are sometimes necessary if there was trauma to the tooth.
Baby teeth can require extraction when they are remaining too long in the mouth. Wisdom teeth need to be removed if there is no space for them to erupt, they are damaging nearby teeth, or they become infected.
How do dentists remove teeth?
Typically, the oral surgeon or dentist doing the extraction will numb the tooth using local anesthesia. The surgeon can also put the patient to sleep to keep the patient comfortable and cooperative while the procedure is done.
When the tooth is numb, the dentist doing the extraction will use forceps, which look like pliers, on the tooth, and rock it back and forth until it comes out. Other tools may also be used to help the tooth loosen and come out.
Occasionally, the surgeon has to cut the tooth into pieces and remove some of the gum tissue to remove the entire tooth.
What is a routine extraction?
A routine dental extraction is also known as a simple extraction. Simple extractions occur when visible teeth are removed. General dentists can typically perform routine extractions.
What is surgical extraction?
A surgical extraction is more complicated. It is the extraction of a tooth in the jaw and requires an incision to be made to remove the tooth. Oral surgeons usually perform these extractions.
When is general anesthesia used for a tooth extraction?
For children and people with high anxiety or behavior problems, extractions are often done under general anesthesia. This means the patient is unconscious during the procedure.
Intravenous sedation can be used to make a patient calm and relaxed during the surgery. If general anesthesia is used, the patient cannot go home alone or drive for 24 hours after the procedure.
Does tooth removal hurt?
A tooth extraction should not hurt. If a simple extraction is done and a local anesthetic is used, you may feel pressure while the tooth is being moved side to side.
If there is pain rather than pressure, the dentist can give more local anesthetic. Under general anesthesia, you are unaware of the pain because you are asleep.
What are the after-effects of tooth extraction?
On the night after a tooth extraction, over 0% of patients say they have had some pain. Teeth that had been inflamed for a long time before they were removed seemed to cause the most post-extraction pain.
Women claimed to have pain more frequently than men did. Non-smokers seemed to experience more pain than smokers. (9)
The rate of infection after extraction is low, but antibiotics are often prescribed to prevent complications. Antibiotics are also prescribed when the surgery was complicated and in patients that have medical conditions such as a compromised immune system, diabetes, or cancer. (10)
Another complication that can arise after a tooth is extracted is numbness in the lips. This is called paresthesia and can last for hours to many months. It happens when the dental nerve is damaged during the surgery. (11)
It is best to keep your teeth clean and healthy to avoid dental decay and periodontal disease. If it becomes necessary to have a tooth extracted, the procedure is usually uncomplicated and safe. Listen to the advice of the dentist who pulled the tooth, and healing should be uneventful.